4th yr placement: HIV/AIDS Services, Hematology and Oncology!

[Jenthenutritionnut]

HELLO!!!

I am posting to celebrate having learned my 4th year, 1st semester placement!!!

I've got three areas: HIV/AIDS inpatient, oncology and hematology...

I'm thrilled and NERVOUS AS HECK! Last year I was in sexual health/abortion care/public health- healthy babies. Soooo it's been a while since I've packed a wound... given a med, calibrated an IV etc.

Any tips, reminders, suggestions as to what to review/explore when it comes to working in any of these areas? I'm thinking IV meds (oncology), sepsis technique for wounds, sub cut injections... any other thoughts??

THANKS for the support!:heartbeat

[Racey328]

First of all CONGRATS! Oncology- Chemo precautions, how to manage side effects of chemo & radiation, different types of chemo & radiation and the precautions you need to teach your patients, what to do in case of a spill, pallitive care, DRUGS, DRUGS, & more DRUGS.

HIV/ AIDS- DRUGS, what to do in case of a needle stick, HIV/AIDS related complications and how to treat them, pallitive care, & patient support.

Hematology- DRUGS, different types of disorders/diseases and how to treat, review your establishments requirements for hanging PRBCs,platelets, etc., diet for patients with certain disorders/diseases, & what to teach. :redbeathe:redbeathe:redbeathe

Good luck!:wink2:

[Jenthenutritionnut]

THANKS Racey!

[K+MgSO4, BSN]

oral assessments would stand out as a biggie to me. All of those pt groups often develop horrible ulcers etc in their mouth and stomasitis. back to the basics oral hygine and oral assessments. Good luck and enjoy your placements

[caroladybelle, BSN, RN]

These actually cross over and often you may have all of these pts on one floor.

I started in ID which for the area, included mostly TB and HIV/AIDs. At that time, AIDS was essentially still a death sentence generally within 2-3 yers of diagnosis. Now we rarely have HIV floors as HIV has become more of chronic illness to manage.

In many places due to immunosuppression issues, AIDs pts were put on Hemo/Onco floors. Also a major issue is that as HIV pts live longer, they are increasingly developing cancers secondary to HIV. Of course there is Kaposi's Sarcoma, but also T-cell and B-cell lymphomas/leukemias, Burkitt's, and a previously rare disorder, Castleman's disease.

Remember that intially, some researchers into HIV (then GRID) debated on HIV beiing another form of the HTLV virus implicated in development of some leukemias. One of the tests for HTLV1/HTLV2 is an elisa test, also used in HIV testing.

Things that all of these pts will have in common are immunosuppression issues, use of multiple antibiotics/antifungals/antivirals, sepsis and infection, mucositis, and cachexia/diarrhea issues.

I personally prefer my work in hematology. There are plenty of jobs and it tends to be more "critical care" than med/surg. Fewer wounds, more juggling antibiotics and multiple lines. Leukemias/Lymphomas can destabilize quickly and easily, when chemo is initiated. They can be quite challenging.

[Jenthenutritionnut]

Thanks. I think that the floor/unit might be all three as you mentioned... I'm really looking forward to all the variety, acuity and challenges. Likely I'll also look forward to the end of the day- as every shift will likely blow my socks off both mentally and physically!